There are some “news” articles which appear to be written with a heavy bias against opioid treatment programs (OTPs). There are not many and they are not widely circulated, and most are not written by journalists. But we asked Mark Parrino, president of the American Association for the Treatment of Opioid Dependence (AATOD), to respond.
“It is also strange that so many professionals and policymakers have misinterpreted a number of policy issues. Illustratively, we are questioned about our concerns about prescribing for methadone products outside of the OTPs since we cite the five methadone mortality reports, which were published by the federal government from 2003 to 2010. The contention is that these are outdated reports. I have pointed out to a number of parties that 2010 does not qualify as ancient history.
“What is even stranger is the contention that these methadone deaths were caused by doctors prescribing methadone for pain management and this would not reoccur when doctors are prescribing methadone to treat opioid use disorder, especially at a time of increasing fentanyl use. The additional claim is that this practice would be limited to a small number of medical specialists and they would know the nuances of titrating methadone doses during a fentanyl epidemic as patients are also using methamphetamines. How do they come by such knowledge? Such practitioners would also be writing for significant supplies of methadone products to be filled by pharmacies even during a period of initial dosage titration. Who considers this a safe practice in view of the clinical challenges of treating fentanyl use during the earlier stages of treatment and we know about the dangers?
“The other issue is the conflicting claim that our fact sheets indicate that it is not at all likely that physicians will perform toxicology screenings or provide counseling or do much beyond the prescribing of medication. They questioned how we could make such a statement. Most of these critics know that the Substance Abuse and Mental Health Services Administration (SAMHSA) did not conduct a comprehensive survey among practicing physicians, who are approved to treat up to 275 patients as part of their buprenorphine practices. If they have gathered such information, a report has not been released to the public. We still do not know what kinds of services are offered in these practices. We know through anecdotal reporting that some DATA 2000 practices are offering comprehensive care and are providing excellent clinical support in addition to the prescribing of medication. We just don’t know how the majority of providers are treating their patients. Interestingly, this lack of knowledge is not preventing legislators or policymakers from wanting to expand access to medication without understanding what is actually happening in such practices.”
It is recognized that different agencies and organizations will view these issues very differently. We all want to save lives and to do so, we must also expand access to effective treatment interventions.
Also attached, see fact sheets from AATOD.
- 6.30.22 OTAA Fact Sheet.pdf
- Fact Checking the Fact Sheet_MAT Act Response_Senate focus 6.22 (002).pdf
- AATOD response re OTAA Fact Sheet 07-18-22.pdf
- AATOD response to MAT Act Fact Sheet 07-18-22.pdf
- Reducing the Risk of AIDS Through Methadone MAaintenance Treatment _John C. Ball Myers Friedman.pdf
- Waivered Practitioners – Summary Breakdown.pdf